<p> INFORMATION FOR PROBATE OF ESTATE</p><p>DATE - - [] TESTATE [] INTESTATE [] ANCILLARY [] SUMMARY ADMIN</p><p>NAME(S) OF DECEDENT DOD </p><p>ADDRESS OF DECEDENT COUNTY </p><p>AGE DOB </p><p>DECEDENT'S SOCIAL SECURITY # TAX I.D.# </p><p>LENGTH OF LAST ILLNESS PLACE OF DEATH </p><p>TREATING PHYSICIAN PHONE # </p><p>ADDRESS </p><p>LAST ILLNESS DEBTS </p><p>FUNERAL EXPENSES </p><p>OTHER OUTSTANDING DEBTS </p><p>SUMMARY OF ESTATE PROPERTY</p><p>REAL ESTATE </p><p>PERSONAL PROPERTY </p><p>INCOME SOURCES [] PENSION $ /MO [] SOCIAL SECURITY $ /MO</p><p>[] OTHER $ /MO [] OTHER $ /MO</p><p>LIFE INSURANCE AMOUNT(S) </p><p>BENEFICIARIES COMPANIES </p><p>DECEDENT BANK ACCOUNT INFORMATION:</p><p>BANK: TYPE OF ACCOUNT </p><p>ADDRESS </p><p>PHONE # ACCOUNT # BALANCE $ BANK: TYPE OF ACCOUNT </p><p>ADDRESS </p><p>PHONE # ACCOUNT # BALANCE $ </p><p>PERSONAL REPRESENTATIVE INFORMATION</p><p>NAME AGE RELATION </p><p>ADDRESS </p><p>PHONE # (H) (W) [] NAMED IN WILL [] STATUTORY</p><p>HEIR, DEVISEE & LEGATEE INFORMATION</p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION </p><p>ADDRESS SOC SEC # </p><p>NAME AGE RELATION ADDRESS SOC SEC # </p><p>SPECIAL INSTRUCTIONS OR NOTES: </p><p>SOURCE OF CLIENT: []REPEAT CLIENT []REFERRED BY []YELLOW PAGES</p><p>ATTORNEY FEES: $ /HR $ FEE RETAINER $ COST RETAINER 03ebab45b650140b59d96039487603ba.docC:\WINDOWS\Desktop\Intake Forms\Finished\probate intake.wpd </p>